Organization
HOLIDAY CVS LLC
Active
Other names
NAVARRO DISCOUNT PHARMACY #10706
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
14665 SW 104TH ST, MIAMI, FL 33186-2976
(305) 636-7779
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012833400
—
FL
01
—
012833401
MEDICAID DME
FL
01
—
1088687
NCPDP
FL
Enumeration date
08/20/2006
Last updated
07/09/2015
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